Savings for taxpayers seen in federal health dollars

AUSTIN — House and Senate leaders are talking up the potential for local tax relief if the state is able to obtain additional federal dollars to provide health care coverage for more poor people without expanding Medicaid.

“To be able to reduce the level of uncompensated care that's paid by local property taxpayers with this money that they will have to pay to the federal government anyway makes sense to me as a fiscal conservative,” Williams said. “We don't want to pay for it twice.”

House Speaker Joe Straus, R-San Antonio, on Wednesday put a spotlight on the health care issue by saying it's time for Republicans to move beyond talking about their firm opposition to expanding the current Medicaid program to crafting an alternative.

Straus said leaders should put forth a Texas-based plan to cover more uninsured people, which could bring billions more federal dollars to the state if approved in negotiations with the federal government.

“I'd like to explore whether some meaningful property tax relief could be part of a Texas solution,” Straus said.

He added that if a plan reduced the burden on local government, “Then I think local taxpayers ought to have an opportunity to have that burden lifted from them.”

Harris County Judge Ed Emmett and Bexar County Judge Nelson Wolff have cited the benefit to local taxpayers in urging Gov. Rick Perry and other state leaders to accept the Medicaid expansion allowed to states under the federal health care law.

People with insurance and taxpayers who support public hospitals now absorb costs for treating uninsured people.

Medicaid expansion would apply to low-income adults who aren't part of the traditional Medicaid program. It would mean an estimated $100 billion more in federal money for Texas over a decade. The state would pay $15.6 billion over that time, and more than 1 million newly eligible people would be covered.

Perry and other Texas Republicans say they won't expand the current Medicaid program because it's broken and costly.

Perry has said he'd like the flexibility that a block grant would bring, but federal officials have indicated such a grant isn't an option.

Sen. Bob Deuell, a Greenville Republican who's Senate Health and Human Services Committee vice chairman, has suggested the state ask for a block grant that would allow private insurance assistance for Texans who otherwise would be eligible for coverage under the expansion.

The potential for subsidies in lieu of Medicaid expansion also has drawn attention from Straus and other top Republicans.

“I think we're all on the same page about wanting to reform Medicaid as it exists, and then doing something as an alternative to expansion,” Deuell said.

Deuell said basic concepts include using private insurance rather than putting more people on Medicaid and such tools as wellness programs, managed care and co-pays.

He also said the state should look at asking for relief on taxes and insurance premiums as part of such a plan since uncompensated-care costs to hospitals and insurers would be lowered.

House Public Health Chairwoman Lois Kolkhorst, R-Brenham, said her focus is getting a full picture of the effect of the federal health care law on Texas, noting that the state's percentage of uninsured people will drop under its provisions regardless of whether a plan also covers people who would be eligible for the Medicaid expansion.